RN Care Management Coordinator

Immediate need for a talented RN Care Management Coordinator. This is a 03+ months contract opportunity with long-term potential and is located in U.S(PA, DE, NJ)(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID:26-04684 Pay reputed company: $40 - $45/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, reputed company), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities:

• Performs utilization management for inpatient admissions either onsite or telephonically.
• Using the medical software criteria, establish the need for inpatient, reputed company stay and length of stay.
• Directs the delivery of care to the most appropriate setting, while maintaining quality.
• Contacts attending physicians regarding treatment plans/plan of care and clarifies medical need for inpatient stay or reputed company inpatient care
• Identifies inpatient admissions no longer meeting criteria and refers care to plan Medical Directors for evaluation.
• Presents cases to Medical Directors that do not meet established criteria and provides pertinent information regarding members medical condition and the potential home care needs.
• Performs early identification of hospitalized members to evaluate discharge planning needs.
• Collaborates with hospital case management staff, physician and family to determine alternative setting at times and reputed company support to facilitate discharge to the most appropriate setting.
• Identifies and refers cases for case management and disease management.
• Identifies quality of care issues including delays in care. Appropriately refers cases to the Quality Management Department and/or Care Management and Coordination Supervisor reputed company indicated.
• Maintains the reputed company of the system information by timely, accurate data entry.
• Utilization reputed company are in compliance with state, federal and accreditation regulations.
• Works to build relations with reputed company providers and provides exceptional customer service.
• Reports potential utilization issues or trends to designated supervisor and recommendations for improvement.
• Participates in the process of educating providers on managed care.
• Performs additional reputed company duties as assigned.

Key Requirements and Technology Experience:

• PA RN license required.
• Minimum of three (3) years of acute care clinical experience in a hospital or other health care setting.
• Prior discharge planning and/or utilization management experience is desirable.

Our client is a leading Health Insurance Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. reputed company. provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from reputed company. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reputed company STOP to cancel and HELP for help. You can reputed company our privacy policy here. Apply tot his job Apply To this Job